Asthma: Your questions

<preform><b>Q:</b> What causes it? Who gets it? And what can we do about it?<br><b>A:</b> Read on, and join our campaign</preform>

What is asthma?

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Asthma: Your letters

What is asthma?

We all have small tubes carrying air in and out of our lungs called airways. The lining of these airways is sensitive in asthmatics, and often becomes inflamed. This can lead to a build-up of mucus that obstructs air meant for the lungs. During an asthma attack the airways become narrower as the muscles around them tighten, making it even harder to breath.

What triggers an attack?

Anything that irritates the airways and causes contraction. Everyone's asthma is different and one person can have several triggers. These may include colds or flu, cigarette smoke, exercise, and allergies to such things as pollen, fur, feathers, or house-dust mites. Poor air quality and pollution from car fumes are often also to blame.

How many people have got it?

One in 12 of us, and growing. There are 1.4 million children and 3.7 million adults currently receiving treatment for asthma in Britain, and another three million people who have been diagnosed with it at some time in their lives. GPs see more than 18,000 new cases every week. Six times more children are treated for asthma attacks now than 25 years ago.

Where does it come from?

Good question. It can be inherited, but many people get it without any family history. Asthma was relatively rare before the First World War, so scientists have been searching our

modern lifestyle for clues as to how people become asthmatic in the first place. The food we eat and the warm, comfortable, centrally heated and poorly ventilated houses we live in might hold clues. Now the findings from California and Nottingham suggest, after years of uncertainty, that the pollution from car exhausts is one of the many causes of asthma.

Should an asthmatic move out of the city?

Not necessarily. The percentage of people with asthma is about the same in the least polluted parts of Britain as in the busiest cities. Asthma is different in every sufferer, so a place that feels good to one person may be disastrous to another. Sometimes people move and feel better for a while, then react to new triggers.

The Nottingham study suggests the closer you live to a main road the more likely you are to become wheezy, but ozone confuses the issue. This poisonous form of oxygen formed by sunlight reacting with the pollutants from cars and some factories is carried away from cities on the wind. So asthmatics who make for the countryside to find cleaner air often find that ozone levels are higher there than in the place they just left.

Is there a cure?

Not yet. Scientists are working on a number of different possibilities including gene therapy. But there are ways to control asthma that enable many sufferers to lead very active lives just like their neighbours.

How is asthma treated?

Most drugs are delivered using inhalers which ensures that very small amounts of medication are delivered directly into the lungs. There are two main types: relievers and preventers. Reliever inhalers are usually blue. They open up the airways by relaxing the muscles around them. Preventers are brown, white, red or orange. They work over a period of time to calm inflammation in the airways and make them less vulnerable to triggers.

Can children grow out of it?

About one in three seem to. Some others find their asthma becomes milder. This is not predictable.

Does smoking make it worse?

Yes. Smoking makes symptoms harder to control and brings a greater risk of other health problems. It may also cause long-term damage to the airways. Passive smoking can also be harmful, and mothers who smoke are more likely to have babies with asthma.

What can we do?

Cutting down the dust in your home and improving the air quality might help. House-dust mites like soft furnishings and carpets, so now is the time to go for stripped pine floors and minimalist chairs. Smoke outside, use a damp duster, and open more windows. Buy a more powerful vacuum cleaner that does not blow dust out of its exhaust. You can buy special bedding, which helps some people.

What about at work?

Have a word with the boss if something is making you feel bad. This could be flour, wood dust, soldering fumes, or isocyanates, pungent chemicals found in paints and varnishes. Protective equipment or improved ventilation might help.

Does the cat have to go?

Possibly. Animals can trigger asthma. Dogs, cats and horses give off allergens. These are minute particles, found in the animal fur, saliva and urine, which get into the air and are breathed in. Most people are not affected; however, allergens play havoc with the sensitive airways of asthma sufferers. It is possible for someone with no history of asthma to become sensitive, suddenly, to a pet they have lived with for a long time. If so it might help to keep the pet outdoors and wash your hands after handling it. Above all, keep Felix out of the bedroom.

Anything else?

Yes. Parents who complain that their children have become asthmatic or got worse because of the busy roads can often be found driving them to school. Clogging the road next to the playground with vehicles can only make things worse, and air quality is poorer inside the car than on the street.

For more information see the National Asthma Campaign's website at www.asthma.org.uk or call its Asthma Helpline on 0845 701 0203.